Vitrectomy combined with endolaser or an encircling scleral buckle in primary retinal detachment surgery: a pilot study

PurposeTo compare pars plana vitrectomy and 360 degrees endolaser therapy with pars plana vitrectomy and an encircling scleral buckle for the treatment of primary rhegmatogenous retinal detachments in a randomized pilot study including 60 patients. MethodsMain outcome measures were single-surgery anatomic success rate and final best-corrected visual acuity at 6months follow-up. Cofactors analysed were complication rates, patients' comfort, refractive outcome and macula status assessed using a spectral-domain optical coherence tomography. ResultsWith differences between both treatment groups regarding type of the retinal detachment, localization of retinal tears (p=0.0085) and the choice of the intraocular tamponade (p<0.0202), there were no significant differences between the single-surgery anatomic success rate (93.33% both groups, p=1.0) and the visual acuity at final follow-up (0.3 logMAR [logarithm of minimum angle of resolution] in 66.67% in the endolaser group versus 40.0% in the scleral buckle group, p=0.0514). Questionnaire responses showed lower levels of patients' discomfort in the endolaser group. A significant difference between both groups was found in the refractive error change after surgery (-0.200.51 dioptres in the endolaser group versus -0.88 +/- 0.88 dioptres in the scleral buckle group, p=0.0003). ConclusionPrimary vitrectomy combined with 360 degrees endolaser therapy seems to be as effective as vitrectomy combined with an encircling scleral buckle in patients with rhegmatogenous retinal detachment, with possible benefits of an improved patients' comfort and a more stable refractive status after surgery.